The US Department of Justice Joins Whistleblower Lawsuits Against UnitedHealth Group Inc.


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Whistleblowers brought two False Claims Act lawsuits for Medicare fraud against UnitedHealth Group, Inc. the first in 2011 and the second in 2014. The U.S. Department of Justice joins these whistleblower lawsuits against UnitedHealth Group, Inc. for Medicare fraud.

On August 28, 2014, the Department of Justice joined the two complaints against UnitedHealth. In both lawsuits, whistleblowers alleged that UnitedHealth billed Medicare for hospice care for patients who did not actually need hospice care. According to the 2011 lawsuit, employees were offered a 20% bonus for a large amount of patients, and penalized if too many patients were discharged because
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they did not require hospice care. The whistleblowers who reported the misconduct were either disciplined or fired as a result.

Whistleblowers are the main source of information regarding employers and companies who engage in misconduct or violate Federal Securities Laws. Recently, there have been changes and improvements to whistleblower protection laws that protect whistleblowers from employer retaliation, but still, whistleblowers are being punished for doing a good deed.

In the lawsuit against UnitedHealth, patients who qualify for hospice care are not expected to live beyond six months. Because of their short time left, hospice care is provided to make the rest of their lives easier and better. In exchange, these patients will no longer receive Medicare coverage, saving them money. However, UnitedHealth’s scheme involved reporting patients who both qualify and more importantly, do not qualify for hospice care to Medicare. By fraudulently reporting unqualified patients to Medicare, UnitedHealth was being paid for hospice services for as long as those patients lived. This misconduct dates back to 2006.

ABOUT THE AUTHOR: Evans Law Firm, Inc.
Ms. Evans is with Evans Law Firm, Inc. in San Francisco and practices in the area of consumer fraud, insurance and elder financial and physical abuse cases, as well as toxic torts. Ms. Evans has represented public entities in private attorney general actions, has extensive experience in complex civil cases and was undefeated in jury trials as a former deputy city attorney in San Francisco. Ms. Evans serves on the Board of Directors for Consumer Attorneys of California and is the first Chair of the Womens’ Caucus. She also serves on the Board of Governors for Public Justice, and the American Association for Justice (formerly ATLA) and is Co-Chair of the Class Action Litigation Group for AAJ.

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Disclaimer: While every effort has been made to ensure the accuracy of this publication, it is not intended to provide legal advice as individual situations will differ and should be discussed with an expert and/or lawyer. For specific technical or legal advice on the information provided and related topics, please contact the author.

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